Low email open rates when using images are multi-faceted. While images themselves may not directly cause deliverability issues, factors such as large image sizes slowing load times, image-heavy emails with low text-to-image ratios triggering spam filters, and email client image blocking can negatively impact open rates. Template length can cause clipping, affecting tracking pixels. Inconsistent rendering of background images and unreliable image hosting contribute to poor user experience. Optimize images for web, use alt text, choose appropriate formats, ensure reliable hosting, personalize/brand images, and ensure images are relevant, and monitor deliverability. Check open rates across providers to identify filtering issues and ensure proper tracking pixel implementation.